To say that COVID-19 changed everything is a bit of an understatement. In fact, during the past two years, the entire dental profession has had to shift how patients are treated to ensure their safety. And although the pandemic still poses threats in terms of fluctuating positivity rates, patients who refuse vaccinations and new iterations of the virus, much of what dental practices put in place during COVID’s peak continue to demonstrate important lessons about infection control and prevention, issues that have become paramount and will continue to be mission critical moving forward.
Lessons from the last pandemic
Not since AIDS has dentistry had to reexamine its practices so urgently in relation to both patient and staff health. In many ways, the lessons learned during the early days of the AIDS crisis proved that the industry can pivot quickly and successfully as new research yields answers to questions about everything from contagiousness to prevention.
The same proved true for this pandemic, but dental practices were now facing respiratory pathogens associated with COVID-19 instead of a bloodborne pathogen.
Fortunately, many infection prevention improvements had already been implemented in response to AIDS more than 30 years ago. For example, all dental clinicians wear gloves when interacting with patients, not just during procedures, and handpieces are sterilized after each use (that wasn’t always true pre-AIDS). Masks and protective eyewear have become standard, although the need for better and increased use of personal protective equipment (PPE) ramped up during COVID.
In the same way that better handling of sharps prevented accidents that could risk infection from bodily fluids, today enhanced air systems, ventilation, office design and social distancing have helped reduce the risk of airborne spread of COVID-19.
Other products that have proved to be effective include disposable plastic cover barriers on operatory light handles, dental chairs, trays and handpiece setups. Ensuring that surfaces prone to contamination are kept clean has had a major impact on reducing potentially infectious agents.
New infection control standards are here to stay
Because COVID-19 is far from being over, many other protocols are becoming standard as the dental profession looks toward the future. In a June 2020 survey, U.S. dentists in both private practices and public health settings said that 99.7% of offices had already implemented enhanced infection control procedures that are still in place. The most common of these newer protocols include frequent disinfection and COVID-19 screening procedures (including temperature checks, social distancing and mask wearing) for staff and patients.
Much of the effort that has gone into rethinking the way dental practices treat patients during the pandemic had as much to do with cleaning and PPE as it did educating patients and staff about risk factors. It has meant standardizing new behaviors that will likely be a part of dentistry well into the future, such as allowing time between patients in operatories where viral particles can linger in the air. Some practices have invested in high-efficiency air filtration systems to reduce the risk and streamline workflows.
When dental practices were shut down because of pandemic risks and lack of PPE, many providers knew they would need to overcome fears about the virus to eventually get back to treating patients. The availability of vaccines changed the way the industry moved forward, but infection prevention and communication remain critical elements to the patient experience.
Positive outcomes
As dentists continue to balance practical protocols with precautions that work, staff and patients seem to have gained a new appreciation for the importance of infection control and prevention practice – many of which have had a positive impact on the most at-risk patients.
For example, research from the Journal of Clinical Periodontology revealed that patients with periodontal disease are nine times more likely to die from COVID-19, three times more likely to be admitted to intensive care and four and a half times more likely to need a ventilator. With this in mind, using products like iodine mouth rinses can help not only deactivate the virus in the oral cavity but also soothe when used as a preprocedure rinse. Some dentists may have only implemented these rinses in response to pandemic risk, but they now see the additional benefits.
Still other dental practices, many of which have added tools like extraoral suction and hospital-grade air purification, are unlikely to go back to working without them. Once again, the pandemic created a reason to take the next step toward even better infection control, a step that may ultimately counter the dangers of whatever the next pandemic may be.
Keeping up and future goals
A good way to keep up with the latest efforts to combat the transmission of COVID-19 in dental practices is to be active in professional organizations and becoming your own advocate. Recommendations can change quickly as we better understand the virus, so being connected to local, state, and national groups can help you navigate new guidelines
This advice is especially crucial for dentists who work across state lines. Protocols in one state may not be relevant in another. Good communication and closely following updates can help alleviate confusion.
In fact, the pandemic has brought many dental practices together. In addition to sharing clinical information, when dental professionals meet through these associations, they’re developing professional friendships during one of the most challenging times in our generation.
Dental professionals have learned much from the past two years that they’ll carry forward in promising new ways. Despite the tremendous loss of life and ongoing challenges, dental industry-leading infection control protocols, ample PPE supplies, antiviral rinses, vaccinations and boosters, and teledentistry have all transformed the industry for the better. Visit the Patterson Dental COVID-19 Resource Center for up-to-date information to help you and your practice navigate the challenges of this ongoing pandemic.
Selected references
Gelburd R. A new study explores COVID-19’s significant impact on the dental industry. U.S. News & World Report. September 18, 2020.
Macri D. The expert advice: Dental patient compliance hinges on effective communication strategies. June 18, 2016. RDH.
Oral Health. The biggest impact of COVID-19 on dentistry. February 8, 2021.
Patton LL. Viral pandemics and oral health: Lessons learned from HIV to SARS-CoV-2. Oral Surg Oral Med Oral Pathol Oral Radiol. 2021;131(2):149-153.
Roark CV. Lessons from the pandemic for dental practices: A year later. Dentistry Today. March 15, 2021.
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A version of this article was originally published in the July 2022 edition of OnTarget. Read the latest edition and view current promotions at pattersondental.com/dental/ontarget.
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